Five Cases of Dental Anomalies Attributable to Congenital Syphilis from Early 20th Century American Anatomical Collections

Specific dental abnormalities are considered pathognomonic of congenital syphilis (CS); however, European physicians recognized their variation during the late 19th to mid 20th centuries. Observations of syphilis-related dental abnormalities in American individuals from similar time periods are made to determine types of variation among the American population. From a survey of the Smithsonian Institution’s National Museum of Natural History anatomical human skeletal collection, five individuals demonstrated dental characteristics consistent with CS (P00011R, P219398, P000707, P000679, and P000161). Hutchinson’s three categories of dental anomalies were used to describe variations among syphilitic individuals. Previously identified pathological dental characteristics related to CS were present in the analyzed individuals. P00011R, 24-year-old Black female, has a maxillary right Moon’s molar. P219398, approximately 20-year-old Black female, has Hutchinson’s incisors and Fournier’s molars. P000707, 26-year-old Black male, displays severe hypoplasia on all incisors, canines and maxillary first molars. P000679, 33-year-old Black female has “screw-driver” shaped maxillary central incisors, altered occlusal morphology of first maxillary molars and hypoplasia. P000161, 45-year-old Black female, demonstrates severe hypoplasia on incisors and canines (molars lost). “Classic” dental characteristics of CS are not ubiquitous to all identified cases. This study exemplifies that dental anomalies associated with CS do not all have to be present for diagnosis. Although other causes for some of these anomalies are possible, observations in these five cases are most consistent with CS